Survey Finds High Death Rates At 2 Central Florida Hospitals

Two Central Florida hospitals had some of the state's highest death rates among Medicare patients in recent years, a new survey of hospital care found.

The Consumers' Guide to Hospitals, as the findings are called, shows that Waterman Medical Center in Eustis and Orlando General Hospital (now Florida Hospital East Orlando) had death rates more than twice as high as some hospitals'.

Administrators at both hospitals said mortality rates do not accurately depict quality of care.

The figures are part of an unusual guide to health care, revealing hospitals where Medicare patient deaths exceeded the national average. Researchers studied Medicare billing records for 1987-89 from all 6,000 acute care hospitals in the nation.

The guide, representing 18 million cases, is the first time Medicare mortality data have been compiled to help people of all ages choose hospitals, said Robert Krughoff, president of the Center for the Study of Services, the Washington consumer advocacy group that published the guide.

''There is a lot of variation with respect to hospital quality from state to state. And there is a lot of variation within each state,'' Krughoff said.

The national average for deaths in those categories is 9 percent. That means 9 percent of all patients treated for the conditions in acute care hospitals did not survive.

Authors of the guide adjusted the percentage to account for such factors as demographics, extreme patient frailty and other complicating conditions that would affect a successful outcome.

Even with adjustments, the overall death rate at Waterman was 11.3 percent for the Medicare-covered conditions. And the death rate for individual conditions and procedures often was 2 percent to 3 percent above national averages.

Of the 255 Medicare hip fractures treated at the hospital during the survey period, for example, 10 percent of the patients died. Nationally, 7 percent of patients died.

''These are old, old folks we're talking about. We're in a very high retirement community,'' said David Beckman, a Waterman vice president. The data are based on what happened to those patients up to 180 days after they left Waterman.

''We may have transferred them out to Shands (Hospital), or ORMC (Orlando Regional Medical Center), or Florida (Hospital). But they show up on our mortality data. We really don't have that many deaths here. That data just means they died.''

Figures for the former Orlando General Hospital, which was bought by the Adventist Health Care System last year, showed an overall death rate of 11.4 percent and rates for individual conditions at or above national averages.

While 3 percent of the country's Medicare patients died after undergoing gall bladder removal, the number at Orlando General was 4.4 percent. ''I wasn't here long enough to be exposed to the old process to compare it to our process,'' said Richard Reiner, administrator of the hospital, now named Florida Hospital East Orlando. ''We like to think of ours as a more comprehensive program.''

He added that mortality data do not give consumers all the information they need when choosing a hospital.

In the guide, Florida Hospital had an overall death rate of 8.4 percent, lower than the national average. The entry included all of the hospital's branches at the time data were collected - Orlando, Altamonte Springs and Apopka.

The Medicare death rate at Orlando Regional Medical Center was slightly above the national average, at 9.3 percent. But ORMC fared well - lower than the national death percentages - in all of the listed areas of cardiac care.

Hospitals in the state with the lowest death rates included Miami Heart Institute, Shands Hospital in Gainesville and West Boca Hospital in Boca Raton.

Statistics in the guide cover 1987-89, the most recent period for which the federal agency that oversees Medicare has complete statistics.

Fred Bodendorf, acting executive director of Florida's Health Care Cost Containment Board, said mortality statistics provide information that can help patients choose hospitals. But such data are not the only criteria consumers should rely on. Second opinions on diagnoses are still a key to receiving good care, Bodendorf said.